LUMENIS Novus Spectra, Operator'S Manual

Page: 86 / 110

Novus Spectra
0642-543-01, Rev A, 12/02
86 Indications for Use
Adverse effects and complications
WARNING - The most common complication of panretinal photocoagulation
is increased macular edema secondary to panretinal photocoagulation, usually
with a concurrent decrease in visual acuity. Visual acuity loss is the result of
redirection of the blood flow from the shunting vessels in the midperiphery
toward the macular region. In addition, blowout hemorrhages from the areas of
neovascularization, particularly on the optic nerve, have been observed, and
may be caused by an increase in peripheral resistance secondary to
photocoagulation, or by an inadvertent Valsalva maneuver by the patient.
WARNING - Only a contact lens specifically designed for use with laser
energy should be used. Use of a standard diagnostic contact lens will result in a
power loss due to reflection from the surface of the lens. The reflected energy
may pose a hazard to both the patient and the physician.
Macular striae and increases in vitreoretinal traction have occurred,
particularly in more advanced cases of proliferative diabetic retinopathy. These
areas, as well as zones along the vitreous base, should be observed closely so
that pars plana vitrectomy can be used, if necessary, to alleviate excessive
vitreoretinal traction caused by the panretinal photocoagulation process.
An increase in lenticular opacities has occurred, although it is doubtful that
the photocoagulation procedure contributed to the process.
1
Precautions
CAUTION - Following photocoagulation, patients should be cautioned
against any activity that could increase the venous pressure in the head, neck,
or eyes, such as straining, lifting, or holding their breath. Patients should be
advised to sleep with the head of their bed elevated 15° to 20°.
CAUTION - Patients should be cautioned against stifling a sneeze, because
this raises the blood pressure within the eyes to a high level. Vigorous nose
blowing should also be discouraged. Rubbing the eyes following
photocoagulation may disrupt blood vessels inside the eyes. Sneezing and
coughing should be controlled with cough syrup or other medications.
CAUTION - Patients should be cautioned, however, against the use of
medications such as nose drops, sprays, inhalators, or other medications that
contain ephedrine or epinephrine, because these drugs tend to elevate
systemic pressure.
CAUTION - Immediately following treatment, patients should avoid altitudes
over 8000 ft. (Commercial aircraft cabins are pressurized below this altitude.)
1. Reference 8, “Ophthalmology References”